Cohen recalls<\/a>, would ask for some guidance on how to answer questions, and clinicians often are only able to say, \u201cOh, just do your best.\u201d<\/p>\nThis is not a great solution \u2013 clinically or scientifically \u2013 notes Cohen. The academic is working on developing scalable digital therapies and studies how to tailor mental health treatments to individual patients to improve outcomes.<\/p>\n
\u201cThis is the questionnaire that everyone fills out, and it\u2019s a such a common experience of being confused \u2013 it\u2019s potentially catastrophic,\u201d Cohen adds. \u201cBecause everything we do in mental health research is dependent on, to a large extent, people\u2019s report of their mental health symptoms, so if you don\u2019t have good data on that, you\u2019re building a house of cards.\u201d<\/p>\n
Frequent symptoms, or frequently bothered by symptoms?<\/p>\n
The study zeroed in on a particularly problematic phrasing in the questionnaire\u2019s instructions, which asks patients to indicate the frequency with which they\u2019ve been \u201cbothered by\u201d any one of a list of symptoms, including oversleeping, overeating, concentration difficulties, being fidgety or restless, and others. The answer options range from \u201cnearly every day\u201d to \u201cnot at all.\u201d<\/p>\n
Cohen asked roughly 850 participants to fill out a Patient Health Questionnaire.\u00a0Subjects were then asked to consider a hypothetical: Imagine they had in fact overslept nearly every day for a week, but that they were not bothered by the oversleeping, perhaps because they were on vacation. They were then asked whether in that scenario they would respond with \u201cnot at all\u201d because they were never bothered, or \u201cnearly every day\u201d because they overslept nearly every day.\u00a0<\/p>\n
Then, they were asked whether their actual answers on the questionnaire they had just completed reflected how often they had experienced the symptoms or how often they were bothered by the symptoms. Finally, they were asked how they would fill out the questionnaire in the future.<\/p>\n
\u201cIf you\u2019re reading the instructions to the letter, you would actually expect a \u2018not at all\u2019 there,\u201d Cohen says, because the patient was never bothered by their sleeping in even though they did it every day.<\/p>\n
Yet the results showed that the instructions were not interpreted consistently among participants \u2013 only 328 participants, or 38%, answered with the correct response \u201cnot at all.\u201d Further, only 146 participants, or 17%, indicated that they would answer based on \u201cbothered by\u201d if they filled out such a questionnaire in the future.<\/p>\n
\u201cIf you\u2019re using smartwatches to do passive sensing of sleep, and everybody is sleeping too much, but half of the people are saying that they sleep too much every day, and half of the people are saying not at all because they\u2019re never bothered by it, then your passive sensing will look like noise when it\u2019s not really,\u201d he added. \u201cEverybody reallyis sleeping too much, but you\u2019re comparing apples and oranges.\u201d<\/p>\n
The results indicate that the test cannot accurately tell providers what patients are experiencing, Cohen said.\u00a0<\/p>\n
\u201cMost of the time when we use these questionnaires we want to know about symptoms of depression, so the \u2018bothered by\u2019 part really matters,\u201d he explains. \u201cThink about the recent explosion of people using GLP-1 weight loss drugs. For someone who is on Ozempic, experiencing reduced appetite probably shouldn\u2019t be counted as an indicator of depression \u2013 that\u2019s the main reason they\u2019re taking the drug.\u201d\u00a0<\/p>\n
Straightforward, comprehensive fix<\/p>\n
The study is only the first step, Cohen notes, toward fully understanding the issues behind these questionnaires. But given how widely the questionnaire is used, he added, the impact could be far-reaching.<\/p>\n
The research has been published<\/a> in the journal JAMA Psychiatry. It is titled \u201cInterpretation Issues With the Patient Health Questionnaire Instructions,\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"Medic assessing records. Image by Tim Sandle Many people, before they sit down with a therapist, need to…\n","protected":false},"author":2,"featured_media":232070,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[10],"tags":[970,163,521,85,46,502,1306,2956],"class_list":{"0":"post-232069","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health","8":"tag-doctors","9":"tag-health","10":"tag-healthcare","11":"tag-il","12":"tag-israel","13":"tag-medical","14":"tag-patients","15":"tag-services"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts\/232069","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/comments?post=232069"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts\/232069\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/media\/232070"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/media?parent=232069"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/categories?post=232069"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/tags?post=232069"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}